Features of Rural Communities in Latin America and Sub-Saharan Africa That Influence Well-Being of Older Persons

Abstract In their recent volume, Critical Rural Gerontology, Skinner et al (2021) challenge us to set aside unidimensional notions of rural communities as bypassed vs very supportive; and to identify the elements of rurality that empower or exclude older people and how these differ across cultures and settings. Covid-19 has highlighted the need for safe and inclusive communities. Given that LMIC will be home to the majority of older adults (Gonzales et al. 2015), we undertook a scoping review of features of rural communities that influence wellbeing of older people in countries across Latin America and Sub-Saharan Africa. The review included literature in English, French, Spanish and Portuguese, using search engines MEDLINE, CINAHL Complete, PsycInfo, SocINDEX, SciELO, AJOL (Africa Journals Online), LILACS, Redalyc, LatinIndex and Clacso. Findings illustrate diversity in how community features including remoteness, infrastructure and belonging influence material, social and subjective wellbeing of older residents.

A representative U.S. sample of adults completed an online survey (N=360) about perceived changes in social health and wellbeing since the implementation of physical distancing restrictions in April. Analyses are conducted on a subsample of adults aged 60+ (n=93; m=65.7 years; SD=4.7). Baseline bivariate descriptive analyses showed no geographic-based differences in self-rated health, resilience, perceived financial wellbeing, or family/friend support measures. Content analysis of rural residents' (n=20) responses about coping strategies and positive experiences across three time points (April/July/November) revealed aspects of resilience. Individuals coped via acceptance and planning; engaging in activities; and keeping with routines. Positive experiences were relatively stable over time, with individuals describing improved health habits and enhanced social connectedness with family/neighbors. Individuals identified societal betterment and saving money as unintended benefits of the efforts to mitigate the spread of COVID-19. When faced with adversity, identifying positive experiences may help individuals cope with challenges in the long-term

COMMUNITY-ENGAGED OLDER ADULT-LED POLICY, SYSTEMS, AND ENVIRONMENT INTERVENTIONS IN THE MS HIGH OBESITY PROGRAM
Masey Smith, 1 Katie Halfacre, 2 Megan Holmes, 2 and David Buys, 3 1. Mississippi State University, Starkville,Mississippi,United States,2. Mississippi State University,MS State,Mississippi,United States,3. Mississippi State University,STARKVILLE,Mississippi,United States Older adults in rural areas are at unique risk for poor outcomes due to social isolation and limited access to resources. The Mississippi High Obesity Program (HOP) aims to enhance access to social connections and resources like community gardens, food pantries, and physical activity as part of its broader objective to prevent and reduce obesity. Through policy, systems and environment strategies, development of Memoranda of Understanding (MOUs) between aforementioned entities, and community based participatory research approaches, Mississippi HOP efforts enhance food systems improvement efforts; grow multi-sectoral collaboration; and evaluate the effectiveness of new policies, and specifically MOUs, in reaching these goals. Older adults represent more than 40% (n=27) of all coalition members and stakeholder leaders (n=61); they are essential for the success of these initiatives. This presentation will highlight the work done during the COVID-19 pandemic and the role of and benefits to older adults, especially ones in rural communities. Maine has a growing number of age-friendly community initiatives (AFCIs); 116 communities are actively working to adapt the social, service, and built environments for aging and 71 have formally joined the AARP Network of Age-Friendly States and Communities. During COVID, rural municipalities were faced with dynamic changes that limited older resident's access to services and social engagement. To overcome these limitations, it is critical for emergent AFCIs to have tools and strategies to maintain and further enhance healthy environments and resilient communities. This study uses group interviews with 6 leaders of established AFCIs and 6 leaders of emergent AFCIs to explore how the Lifelong Fellows Program, a peer mentoring model that matches experienced leaders with newly formed initiatives, was able to spur development of new strategies to build community resilience. Prominent themes were (1) engaging new local and regional partners; (2) intergenerational volunteerism;

PEER MENTORING TO FOSTER RESILIENT AGE-FRIENDLY RURAL COMMUNITIES IN MAINE
(3) fun and flexibility; and (4) relationship-building.

FEATURES OF RURAL COMMUNITIES IN LATIN AMERICA AND SUB-SAHARAN AFRICA THAT INFLUENCE WELL-BEING OF OLDER PERSONS
Andrew Banda, 1 Norah Keating, 2 Jaco Hoffman, 3 Jose Parodi, 4 and Nereide Curreri, 5 , 1. University of Zambia,Lusaka,Lusaka,Zambia,2. Swansea University,Swansea,Wales,United Kingdom,Vanderbijlpark,Gauteng,South Africa,4. San Martin de Porres University,Lima,Lima,Peru,South Africa,Vanderbijlpark,South Africa In their recent volume, Critical Rural Gerontology, Skinner et al (2021) challenge us to set aside unidimensional notions of rural communities as bypassed vs very supportive; and to identify the elements of rurality that empower or exclude older people and how these differ across cultures and settings. Covid-19 has highlighted the need for safe and inclusive communities. Given that LMIC will be home to the majority of older adults (Gonzales et al. 2015), we undertook a scoping review of features of rural communities that influence wellbeing of older people in countries across Latin America and Sub-Saharan Africa. The review included literature in English, French, Spanish and Portuguese, using search engines MEDLINE, CINAHL Complete, PsycInfo, SocINDEX, SciELO, AJOL (Africa Journals Online), LILACS, Redalyc, LatinIndex and Clacso. Findings illustrate diversity in how community features including remoteness, infrastructure and belonging influence material, social and subjective wellbeing of older residents.

SHIFTING ISSUES OF SUPPORT EXCHANGE UNDER 20-YEAR IMPLEMENTATION OF JAPANESE LONG-TERM CARE INSURANCE PROGRAM Chair: Tomoko Wakui
Japan has faced numerous issues in the last twenty years with its mandatory long-term care (LTC) insurance program. This LTC insurance program obviously affected older adults' informal support exchanges, reducing support from family and the community, which became more valuable, subjectively. Furthermore, changes in support have impacted older adults' subjective well-being and children's perceived care motivation. Additionally, a mandatory uniform system challenges the issue of tolerance of diversity, meaning how non-traditional families' opinions be involved LTC situations. This symposium discusses unexpected shifting issues in Japan in the implementation of a public LTC program with a focus on older adults' support exchanges. The first paper examines the long-term impacts of formal and informal support by examining the effects of implementing formal services. The second paper assesses a community's role in relation to family in the presence of a public LTC program. The third paper examines the subjective impacts of older parents, who provided support to adult children and their reciprocal expectations of receiving LTC. The fourth paper, on the other hand, articulates reciprocal impacts on sons' care motivation, which has become more important, since the introduction of the LTC program reinforced men's participation in LTC. Finally, the fifth paper clarifies how a public uniform program accommodates informal support from non-traditional families when the program premises the presence of family in advanced care planning. Our findings have long-term implications for aging societies in relation to formal and informal support exchanges.

TRENDS IN INFORMAL AND FORMAL LONG-TERM CARE USE AMONG OLDER ADULTS WITH DISABILITIES IN JAPAN
Yoko Sugihara, 1 Erika Kobayashi, 2 Taro Fukaya, 3 Jersey Liang, 4 and Hidehiro Sugisawa, 5 1. Tokyo Meropolitan University, Tokyo, Tokyo, Japan, 2. Tokyo Metropolitan Institute of Gerontology, Tokyo,Japan,3. Tokyo Metropolitan Institute of Gerontology,Tokyo,Tokyo,Japan,4. School of Public Health,University of Michigan,Ann Arbor,Michigan,United States,5. J.F. Oberlin University,Tokyo,Tokyo,Japan Whether increased formal long-term care (LTC) reduces informal LTC use by serving as a substitute or has a complementary role that boosts both informal and formal LTC use has been an important issue for evaluating LTC policy effectiveness. We described trends in in-home LTC use among older adults and LTC availability in relation to changes in LTC policy in Japan. In addition, we examined whether these trends differ by living arrangements, gender, income, and disability levels. We used five waves of repeated cross-sectional data starting in 1999 to 2017. The use of both informal and formal LTC types combined increased until 2006 and then gradually decreased while remaining higher than in 1999. Although implementing the LTC program may have temporarily contributed to the complementary use of both LTC types, eligibility limitations brought about by LTC reform potentially reduced the effects of formal LTC's complementary role.

NEIGHBORHOOD RELATIONSHIP MATTERS FOR WHOM?: INTERACTION WITH FAMILY STRUCTURE AND FUNCTIONAL CONDITIONS
Erika Kobayashi, 1 and Ikuko Sugawara, 2 1. Tokyo Metropolitan Institute of Gerontology, Tokyo,Japan,2. Bunri University of Hospitality,Tokyo,Japan Living environment is considered to have unignorable effect on our health and well-being, especially when we face shrinkage of mobility as we age. Social interaction with neighbors constitutes our social environment, and it may affect our well-being by interacting with other social resources such as support from family and professional care providers. In this study we examined the effect of social environment in neighborhood on older people's well-being, and how its effect is moderated by their family structure, functional conditions, and LTC service usage. Data was obtained from the survey conducted in 2012 with nationally representative sample of Japanese adults aged 60 years and older. The results showed that for people with functional limitation but were not certified as needing LTC, neighborhood social network was positively associated with well-being. These results suggest the unique function of neighbors for frail people to keep everyday life in the community.

WHEN DOES SUPPORT TO ADULT CHILDREN NEGATIVELY AFFECT THE SUBJECTIVE WELL-BEING OF OLDER JAPANESE? Erika Kobayashi, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
Providing time and money to adult children may enhance perceived usefulness and consequently the subjective well-being (SWB) of older parents. However, non-reciprocal relationships with children and conflicts with leisure activities could negatively affect parents' SWB. It was hypothesized that a substantial amount of support to children would be associated with lower SWB when older parents (a) had a low expectation of receiving long-term care from the children, and (b) were engaged in hobbies/learning activities. Life satisfaction and depressive symptoms measured as SWB were predicted based on the Generalized Estimating Equations, using panel data (2012-2017) with a nationwide representative sample of Japanese adults aged 60 years and older (1,212 parents). Providing child-rearing support (i.e., grandchild care) of 30 hours or more per month was positively associated with SWB regardless of conditions (a) and (b).